Community Pharmacies

Mark Hendrick Excerpts

Thursday 14th September 2023 Westminster Hall

[Several hon. Members rose—]

[Sir Mark Hendrick (in the Chair)]

Order. May I remind Members that they need to bob if they wish to be called?

--- Later in debate ---

[Taiwo Owatemi (Coventry North West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Mark. I thank the hon. Member for Waveney (Peter Aldous) for securing this important debate and highlighting the challenges faced by the pharmacy sector. He spoke with great knowledge about many of the challenges around funding, and the opportunities for the pharmacy sector to address some of the primary care challenges faced by the NHS. I highlight the points made by the Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), who has been very supportive of the pharmacy sector and has played a key role in pushing for the Committee to publish a report on the role of the sector and the challenges it faces.

I declare an interest as a registered pharmacist, the chair of the all-party parliamentary pharmacy group, and a member of the Health and Social Care Committee. I apologise to Members present, as I might end up repeating some of the points that have already been made, but I will try my best not to focus on them.

The first challenge I will highlight is the massive issue of the medicine supply chain. Every time I speak to pharmacy owners and pharmacists they raise the impact that uncertainty has on their profit margins. I recently started engaging with the pharmaceutical sector to understand the issues. There are issues around medicine distribution in this country, and there are middlemen supply chain distributors who keep hold of medicines and who are sometimes involved in driving up the prices, but we also have challenges around the manufacturing of generics, which account for about 80% of medicines used by the NHS.

About 2.2 million generic drugs are prescribed every single day in this country and used by the NHS. Despite that, it seems there were some oversights in this area when we negotiated our exit from the EU. Currently, legislation allows EU generics to be recognised in the UK but does not allow the EU to recognise UK generics. That means that British manufacturers are unable to submit their marketing authorisation applications easily within the EU. Therefore, they have no incentive to produce these medicines, or increase their manufacturing of these medicines, in the UK. It also means that they are unable to compete with their European competitors.

A great example of what is happening is that the EU has started investing about £20 billion in the manufacturing of generics since we left. So far, the UK, according to figures that I have seen recently, has invested nothing. Essentially, our UK manufacturers are being left at a competitive disadvantage. Aside from that, the Medicines and Healthcare products Regulatory Agency is facing significant challenges. It has lost a large amount of its workforce and is currently unable to process the regulatory applications coming through its doors—again, making it difficult for generic drugs to enter the UK. Essentially, there are regulatory difficulties and there seem to be limited financial incentives.

Secondly, I want to address the challenges of finance, which have been a massive issue facing the pharmacy sector. The sector has not been adequately funded in line with inflation for a very long time. That has led to many high street pharmacies closing down. In my constituency, Boots in Jardine Crescent had to close down because it was not financially viable for the business to continue. That has had a significant impact in an area of great deprivation and high health inequality.

Despite the challenges that community pharmacies face, there are also wonderful opportunities, which I have to admit the Government have started to recognise. I welcome their more than £600 million investment in the Pharmacy First programme, but there is a long way to go to fully take advantage of the potential that community pharmacies can offer.

Community pharmacies play an important role because they are the first point of call for patients, but they can play a bigger role in healthcare. Not only can they deliver the Pharmacy First scheme—I hope that will be rolled out and that the Government will add more clinical conditions to the list—but they can play an important role in other primary care services, such as vaccination, sexual health and the management of conditions such as cardiovascular disease.

I have always found it weird how a patient will come up to me in the pharmacy and say, “I have high blood pressure. I’m a bit concerned.” I say, “Sit down. Let’s check your blood pressure” and then I have to message the doctor to let them know. Then I will tell the patient to go to their GP to get a medication. In reality, that could have started and ended in a community pharmacy. That is something that hospital pharmacists easily do, and we regularly do it, so I encourage the Minister to look into the wider roles that community pharmacists can play in supporting GPs and primary care and in reducing some of the challenges it currently faces.

Many Members have spoken about the workforce crisis. To be able to fully take advantage of the potential of community pharmacy, we have to acknowledge the fact that, like many other healthcare professions in this country, pharmacies face a significant workforce crisis. We do not have enough pharmacists, and we are struggling to recruit and train more and to retain the community pharmacists we have.

Again, I welcome the Government’s workforce plan, but unfortunately it lacks the finer details of how community pharmacy will be supported in the long term. An integrated and funded workforce plan for pharmacy is needed if we are to enable pharmacies to support the community as well as the rest of the NHS. A larger number of designated prescribing practitioners is needed if community pharmacies are to assist with the provision of primary care. A clear pathway to ensure that that happens is important.

I know that the Government aim to ensure that we get as many prescribers as possible by 2026, and that is something I welcome. I am really happy that pharmacists are able to graduate with the ability to prescribe. However, there are many pharmacists in the workforce for whom there is no clear plan as to how they can become prescribers by 2026. I have spoken to many different pharmacy schools and they do not know how that is going to happen.

As the hon. Member for Waveney has explained, the process for getting sign-off is not easy. People have to ensure that they have found the right healthcare professional to shadow, as well as take time off work to do all the documentation and paperwork that is needed. Changes therefore need to happen, and further funding needs to be made available to incentivise healthcare professionals to take on more pharmacists and to mentor them and train them to become prescribers.

I also want to address areas that have not been mentioned in the debate so far. The first is technology, which has played a significant and positive role in the provision of the healthcare system. Since covid, technology has played an important role in allowing patients to have easy access to healthcare and allowing them to feel empowered. That is the reason we have seen an increase in the number of online pharmacies that are available, which has been quite positive.

However, I have some concerns. Figures recently published by the General Pharmaceutical Council, which is responsible for inspecting community pharmacies and online pharmacies, show that at least one in five of the online retailers it inspected in the past year did not meet at least one standard. If that was a community pharmacy, the store would be put on a clear supervision pathway to ensure that patients’ health was not put at risk. I would like to see the same happen to online pharmacies to ensure that they are better regulated as they continue to provide better access to medicines for patients.

I welcome the fact that the Government are looking at the supervision rules, which are outdated and were created at a time when we were making medicines in pharmacies and playing around with different active pharmaceutical ingredients. Pharmacy has changed since then, and the information available and the regulation around drug manufacturing has significantly improved. I welcome the consultation that is being carried out, and I encourage as many pharmacists as possible to give their feedback and engage with the consultation.

Lastly, I want to turn to the regulation of non-clinical managers. Community pharmacies either have a pharmacist as a manager or have non-clinical managers leading them. In the light of the Lucy Letby case, which highlighted the important role that non-clinical managers play, it is important that community pharmacists are also considered. Any new regulatory framework for unregulated management and leaders in healthcare should apply to not only those working in the NHS but those who have direct involvement in the provision of healthcare in our communities, such as community pharmacy.

Before I end, I would like to ask the Minister a few questions, which I hope he can answer today or respond to in a letter. Has any consideration been given to the generic industry, which, as I said earlier, accounts for a large amount of medicine supplies within the NHS? Can he direct me to the Minister who is responsible for drug manufacturing in this country, the changes in EU legislation and how we can bring about positive changes for our generic manufacturing industry? Do the Government have any plans to prevent future medicine shortages? I am already hearing pharmacies expressing concerns about the fact that winter is coming and they are expecting to have further shortages.

Are there any updates on the mutual recognition of medicines within the EU, and are any negotiations happening? Can the Minister provide an update on the prescribing scheme for healthcare professionals and whether any steps have been taken to address the issues I have raised? On funding, it would be helpful for many pharmacists to know whether there are any plans to help address some of the financial challenges they face. Lastly, as the chair of the all-party parliamentary pharmacy group, I wonder whether the Minister could spare some time to come and speak to key stakeholders in the sector, who would love to meet him and share some of their experiences.

[Sir Mark Hendrick (in the Chair)]

I thank Members for keeping to time. I call the shadow Minister.